结缔组织病肌筋膜炎的MR和CT表现与穿刺活检的对照研究  

The diagnosis of MR and CT sacn for myofascitis of connective tissue disease:comparison with biopsy examination

作　　者：许建荣[1] 周滟[1] 柴维敏[1] 姚秋英[1] 李磊[1] 李岚[1] 李政扬[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,200001

出　　处：《中华放射学杂志》2002年第9期824-828,共5页Chinese Journal of Radiology

摘　　要：目的　了解结缔组织病肌筋膜病变的影像表现特点 ,以及MRI、CT的应用价值。方法经临床诊断的结缔组织病 2 2例 ,其中皮肌炎 (DM) 8例、多肌炎 (PM) 12例和嗜酸性筋膜炎 2例。所有病例均完成大腿CT平扫、MR的T1WI、T2 WI、频率预饱和反转恢复 (SPIR)序列及CT导向经皮穿刺活组织检查。结果　穿刺活检、MRI和CT发现肌组织病变分别有 17例、14例和 5例 ,发现筋膜病变分别为 5例、9例和 9例。肌炎、肌萎缩、筋膜炎可单独或合并存在 ,肌炎 (9例 )呈现T1WI低信号和T2 WI或SPIR高信号改变 ,肌萎缩 (9例 )呈T1WI、T2 WI高信号以及肌间隙增宽。SPIR检出肌炎明显优于CT和T1WI,P <0 .0 5。DM(6 / 8)的发生率明显高于PM(3/ 12 ) ,P <0 .0 5。病情加重期肌炎 (7/ 11)的发生率明显高于缓解期 (2 / 11) ,P <0 .0 5。结论　MRI和CT能够客观地反映结缔组织病肌筋膜病变的类型。Objective To evaluate the utility of MRI, CT and biopsy examinations in detecting myofascitis lesions of connective tissue disease. Methods The study group consisted of 22 patients proven by clinical features and laboratory examination, including 8 cases of dermatomyositis (DM), 12 cases of polymyositis (PM), and 2 cases of eosinophilic fasciitis. All patients received CT scan, SE T 1WI, SE T 2WI, SPIR, and CT guiding biopsy at the thigh region. Results Biopsy detected muscular diseases in 17 cases and fascitis in 5 cases. MRI detected muscular diseases in 14 and fascitis in 9. CT detected muscular diseases in 5 and fascitis in 9. Myositis, amyotrophy, and fascitis may be alone or united in one case. Myositis (9 cases) appeared as low signal on T 1WI and high signal on T 2WI or SPIR. Amyotrophy (9 cases) presented hyperintensity on both T 1WI and T 2WI. SPIR was more sensitive in detecting myositis than CT and T 1WI, P <0.05. Myositis was more frequent in cases with DM (6/8) than in cases with PM (3/12), P <0.05. Also, myositis was more frequently encountered in active phase (7/11) than in quiescent phase (2/11). Conclusion MRI and CT appear to be valuable in quantitatively and qualitatively estimating myofascitis of connective tissue diseases.

关 键 词：结缔组织病 肌筋膜炎 多发性肌炎 磁共振成像 CT 活组织检查 对比研究 

分 类 号：R445[医药卫生—影像医学与核医学]